Overview
This trial is a single-arm, single-center, open-label clinical trial to evaluate the safety, efficacy, and metabolism kinetics of CT071 in patients with high-risk newly diagnosed multiple myeloma.
Description
This trial is a single-arm, single-center, open-label clinical trial to evaluate the safety, efficacy, and metabolism kinetics of CT071 in patients with high-risk newly diagnosed multiple myeloma (HRNDMM).
Eligibility
Inclusion Criteria:
Participants must meet all of the following criteria to be enrolled:
1.Volunteer to participate in the clinical trial; the participants themselves fully
understand and are informed of this study, and sign the informed consent form and are
willing to follow and able to complete all trial procedures;
2.Age ≥ 18 years, male or female;
3.Participants must have newly diagnosed with multiple myeloma according to International
Myeloma Working Group diagnostic criteria 2014 ;
4.Measurable disease based on at least one of the following parameters (International
Myeloma Working Group consensus criteria for response and minimal residual disease
assessment in multiple myeloma 2016); the values for these parameters obtained up to 60
days prior to signing the Informed Consent Form including the results at the time of
diagnosis may be used.
1. Serum M-protein ≥ 1.0 g/dL;
2. Urine M-protein ≥ 200 mg/24 hr;
3. Serum free light chain (FLC): involved FLC level ≥ 10 mg/dL (100 mg/L) provided serum
FLC ratio is abnormal.
5.Known to have the following high risk factors, i.e. At least one of the following
conditions is met:
1)Meet any one or more of the cytogenetic criteria: del (17p); t (4; 14); t (14; 16);
t (14; 20); 1q21 amplification ≥ 4 copies; 2)R-ISS stage 3; R2-ISS stages 3 and 4;
3)Presence of soft tissue extramedullary plasmacytoma 4)2%-5% in peripheral plasma
cells;
6.Eastern Cooperative Oncology Group (ECOG) score 0-2;
7.Participants should meet the following test results (repeat tests are allowed):
1)Hematology: Absolute neutrophil (ANC) count ≥ 1.0 × 109/L; Platelet (PLT) ≥ 50 ×
109/L; Hemoglobin (Hb) ≥ 7.5 g/dL; 2)Blood chemistry: Endogenous creatinine clearance
≥ 40 mL/min (see Appendix 1 using the Cockcroft-Gault formula); Alanine
aminotransferase (ALT) ≤ 2.5 × upper limit of normal (ULN), aspartate aminotransferase
(AST) ≤ 2.5 × ULN, total bilirubin ≤ 1.5 × ULN; 3)International normalized ratio
(INR), or activated partial thromboplastin time (aPTT) ≤ 1.5 × ULN.
8.Venous access required for collection can be established and there is no
contraindication for cell collection.
9.Females of childbearing potential (WOCBP) must have a negative serum pregnancy test
at screening and must be willing to use effective and reliable contraception for at
least 12 months after CT071 infusion.
10.A male participant, if sexually active with a female of childbearing potential, is
willing to use a highly effective and reliable method of contraception for 1 year
after receiving trial treatment. All male participants absolutely refrain from
donating sperm during the trial and for 1 year after receiving trial treatment.
Exclusion Criteria:
Participants were not enrolled in the trial if they met any of the following criteria:
1. Patients with non-secretory MM.
2. Prior treatment for MM other than up to 2 cycles of (bortezomib, lenalidomide,
dexamethasone) for induction, including but not limited to cytotoxic therapy,
proteasome inhibitors, immunomodulators, targeted therapy, radiotherapy (patients
are eligible for this trial if the radiation field covers ≤ 5% bone marrow
reserve regardless of the end date of radiotherapy), epigenetic therapy, etc.
3. Pregnant or lactating females.
4. Patients with severe mental disorders or altered mental status, history of
central nervous system disease, such as epilepsy, intracranial hemorrhage,
paralysis, aphasia, stroke, severe brain injury, dementia, Parkinson's disease,
cerebellar disease, memory impairment, spinal cord compression, psychiatric
disease or any disease involving the central nervous system, or suspected central
nervous system (CNS) metastasis, or any autoimmune disease involving the CNS,
with or suspected CNS infiltration.
5. Participants had other malignancies, including the following that were considered
to have been successfully treated: non-metastatic basal cell or squamous cell
skin cancer, non-metastatic prostate cancer, carcinoma in situ of the breast or
cervix, and non-muscle invasive bladder cancer.
6. Active autoimmune disease that results in end organ damage or requires systemic
immunosuppressive/systemic disease modifying drugs, including but not limited to
Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus and other
patients requiring long-term immunosuppressive therapy.
7. Have any uncontrolled active infection (defined as exhibiting persistent signs or
symptoms associated with infection that do not improve despite appropriate
anti-infective therapy), or other serious active viral, bacterial, or
uncontrolled systemic fungal infection. I
8. Positive test results for biomarkers of any of the following pathogenic
microorganisms: human immunodeficiency virus (HIV) antibody, Treponema pallidum
antibody (TPPA), hepatitis C virus (HCV) antibody, hepatitis B virus (HBV)
surface antigen (HBsAg) (core antigen [HBcAb] positive must have DNA copies below
the lower limit of normal).
9. Vaccination with live attenuated vaccine or mRNA vaccine within 8 weeks and
inactivated vaccine within 4 weeks prior to screening.
10. Patients who are allergic or intolerant to lymphodpletion drugs, tocilizumab, or
allergic to the ingredients of CT071 cell infusion preparation (DMSO); Or
previous history of other severe allergies, such as anaphylactic shock.
11. Clinically significant cardiac abnormalities, including but not limited to:
1)Uncontrolled congestive heart failure (New York Heart Association Class III or IV
heart failure, see Appendix 3); 2)Myocardial infarction, coronary artery bypass
grafting or unstable angina within 6 months prior to apheresis; 3)History of
clinically significant uncontrolled cardiac arrhythmias such as ventricular
arrhythmias; 4)History of severe non-ischemic cardiomyopathy; 5)Left ventricular
ejection fraction (LVEF) < 50%, diagnosed by echocardiography, without clinically
significant ECG abnormalities; 6)Other heart disease that, in the opinion of the
investigator, may jeopardize the health of the participant when participating in this
clinical trial.
12.Participants with known or suspected chronic obstructive pulmonary disease (COPD)
with a forced expiratory volume in 1 second (FEV1) < 50% of the predicted normal value
of spirometry, or other lung disease that, in the judgment of the investigator,
significantly affects lung function or affects the safety of the participant, such as
asthma, interstitial lung disease, diffuse lung disease, pulmonary infection,
pulmonary embolism, etc.
13.No need for supplemental oxygen for maintenance and oxygen saturation < 92% in room
air.
14.Participant has a history of stroke or seizure within 6 months prior to the
screening period.
15.Has had major surgery before screening, or is planned to undergo major surgery
after the trial treatment (excluding cataract and other surgery under local
anesthesia). The investigator must discuss with the sponsor to determine whether a
surgery is major surgery before enrolling the participant in the trial.
16.The participant has not recovered to Common Terminology Criteria for Adverse Events
(CTCAE) v5.0 ≤ Grade 1 from toxicities attributable to previous treatments, except for
alopecia, peripheral neuropathy, and other events that, in the judgment of the
investigator, are unlikely to result in lymphodepletion or cumulative toxicities of
CT071 treatment; 17.Other conditions considered inappropriate for participation in
this clinical trial by the investigator.